Individual provider Active NPI

Heather Anne Hanlon, O.D.

  • Optometrist
  • Waldorf, MD
National Provider Identifier
1023318227
Registry record updated Dec 16, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TA2223 Issued in MD
Practice address
11110 Mall Cir
Box 6140
Waldorf, MD 20603-4803
Phone
(301) 705-8450
Fax
(301) 705-8448
NPI assigned
Oct 22, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 16, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPC4588 FL
Optometrist 152W00000X TA2223 MD Primary

Addresses

Primary practice location

11110 Mall Cir
Box 6140
Waldorf, MD 20603-4803

Mailing address

11110 Mall Cir
Box 6140
Waldorf, MD 20603-4803
Phone (301) 705-8450

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161019001882 MD Practitioner - Optometry 4284829300 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Dr Anup K Panjwani and Associates Inc Optometrist CurrentSince Mar 12, 2018 Accepting new patients
Pinellas Eye Care PA Optometrist Past Accepting new patients
Victor T Nothnagel OD PA Optometrist PastSince Jan 4, 2012 Accepting new patients

Locations

40 Drury Dr
La Plata, MD 20646
Phone (301) 392-9106

11930 Acton Ln
Waldorf, MD 20601
Phone (240) 435-4822

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1287705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418688000000",
    "number": "1023318227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11110 MALL CIR",
            "address_2": "BOX 6140",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206034803",
            "telephone_number": "301-705-8450",
            "fax_number": "301-705-8448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11110 MALL CIR",
            "address_2": "BOX 6140",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206034803",
            "telephone_number": "301-705-8450",
            "fax_number": "301-705-8448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANLON",
        "first_name": "HEATHER",
        "middle_name": "ANNE",
        "name_prefix": "Ms.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-10-22",
        "last_updated": "2014-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC4588",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MD",
            "license": "TA2223",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waldorf, MD

Sources for this page

Verify at the official NPI Registry.